Raymond S Niaura
Raymond S Niaura
Scroll
Professor of Social and Behavioral Sciences
-
Professional overview
-
Dr. Raymond Niaura is a psychologist and an expert on tobacco dependence and treatment, as well as substance use and addiction to alcohol. Dr. Niaura researches the biobehavioral substrates of tobacco dependence, including factors that influence adolescent and early adult tobacco use trajectories. He also evaluates behavioral and pharmacological treatments for tobacco cessation, with a particular interest in cessation in disadvantaged population to address public health disparities in tobacco-related burdens of illness and disability.
For eight year, Dr. Niaura was the Director of Science and Training at the Schroeder Institute (SI) for Tobacco Research and Policy Studies at the Truth Initiative, where he also supervised the pre- and post-doctoral training programs. Dr. Niaura has previously taught and conducted research at Brown University, Johns Hopkins Bloomberg School of Public Health, the Georgetown Medical Center, and the School of Public Health at University of Maryland. He was also a former President of the Society for Research on Nicotine and Tobacco and is a Deputy Editor of the Nicotine and Tobacco Research.
With grants from the National Institutes of Health, numerous foundations, and private industry, Dr. Niaura has published over 400 peer-reviewed articles, commentaries, and book chapters, including the book The Tobacco Dependence Treatment Handbook: A Guide to Best Practices.
-
Education
-
BA, Psychology (First Class Honors), McGill University, Montreal, CanadaMS, Psychology, Rutgers University, New Brunswick, NJPhD, Psychology, Rutgers University, New Brunswick, NJ
-
Honors and awards
-
Research Laureate, American Academy of Health Behavior (2009)University Scholar Award, McGill University (1979)
-
Areas of research and study
-
Alcohol, Tobacco and Driving PoliciesEvaluationsHealth DisparitiesSubstance AbuseTobacco Control
-
Publications
Publications
Chapter 4. Nicotine Addiction: Past and Present
Niaura, R. (n.d.). In How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General (1–).Publication year
2010Effects of nicotine withdrawal on verbal working memory and associated brain response
AbstractSweet, L. H., Mulligan, R. C., Finnerty, C. E., Jerskey, B. A., David, S. P., Cohen, R. A., & Niaura, R. S. (n.d.).Publication year
2010Journal title
Psychiatry Research - NeuroimagingVolume
183Issue
1Page(s)
69-74AbstractPrevious literature has reported effects of nicotine withdrawal on brain function during cognitive tasks such as verbal working memory (VWM). Mechanisms of these withdrawal effects have not been clearly identified. Functional neuroimaging offers an objective method to examine brain mechanisms associated with observable behavior and subjective reports. To investigate these mechanisms, 12 smokers were administered a 2-Back VWM challenge during two functional magnetic resonance imaging sessions. Participants abstained from smoking prior to both sessions; however, they applied a nicotine patch before one session and a placebo patch prior to the other. Among regions that exhibited a significant response to the 2-Back during either session, withdrawal was associated with significantly greater deactivation in left and right temporal poles and left medial frontal gyrus. The magnitude of task-related activation showed a significant inverse relationship to craving in the majority of regions during placebo administration. Also, individual brain responses varied more during placebo, suggesting inefficient neural processing. Results suggest that differences in brain response to a VWM challenge during abstinence may be attributed to increased craving. Further deactivation of regions associated with the default network (medial frontal and anterior temporal clusters) during the placebo condition suggests further suspension of default activity, possibly to compensate for inefficient neural processing.Measuring smoking-related preoccupation and compulsive drive: Evaluation of the obsessive compulsive smoking scale
AbstractHitsman, B., Shen, B. J., Cohen, R. A., Morissette, S. B., Drobes, D. J., Spring, B., Schneider, K., Evans, D. E., Gulliver, S. B., Kamholz, B. W., Price, L. H., & Niaura, R. (n.d.).Publication year
2010Journal title
PsychopharmacologyVolume
211Issue
4Page(s)
377-387AbstractRationale: Tobacco use for many people is compulsive in nature. Compelling theories of how smoking becomes compulsive exist but are largely based on extrapolation from neuroscience findings. Research on smokers is impeded, in part, by a lack of instruments that specifically measure compulsive smoking. Objective: This study evaluated the measurement structure and validity of the Obsessive Compulsive Smoking Scale (OCSS), a ten-item questionnaire designed to measure compulsive smoking. Methods: Participants were 239 daily smokers (≥1 cigarette/day), including 142 students at a public university in Chicago and 97 veterans treated at the VA Boston Healthcare System. The OCSS and questionnaires measuring current and past smoking, cigarette craving, automatic smoking, and nicotine dependence were administered. Results: Factor analysis with maximum likelihood extraction and oblique rotation revealed two correlated underlying factors, interpreted as "Preoccupation with Smoking" and "Compulsive Drive." The measurement structure was consistent across students and veterans, and confirmed in an independent sample of adults (n∈=∈95). Veterans exhibited higher OCSS scores (full scale and subscales) than students. Across groups, higher OCSS scores were positively correlated with smoking intensity, craving, and nicotine dependence. OCSS full-scale and compulsive drive scores, but not smoking preoccupation scores, were inversely correlated with past month smoking reduction and minutes since last cigarette. Conclusions: The OCSS is a valid and reliable inventory for measuring the degree to which daily smokers are preoccupied with smoking and engage in compulsive tobacco use, and may be useful for advancing understanding of core smoking phenotypes or for tailoring cessation therapies.Menthol and non-menthol smoking: The impact of prices and smoke-free air laws
Relationships of personality and psychiatric disorders to multiple domains of smoking motives and dependence in middle-aged adults
Sex differences in TTC12/ANKK1 haplotype associations with daily tobacco smoking in Black and White Americans
AbstractDavid, S. P., Mezuk, B., Zandi, P. P., Strong, D., Anthony, J. C., Niaura, R., Uhl, G. R., & Eaton, W. W. (n.d.).Publication year
2010Journal title
Nicotine and Tobacco ResearchVolume
12Issue
3Page(s)
251-262AbstractIntroduction: The 11q23.1 genomic region has been associated with nicotine dependence in Black and White Americans. Methods: By conducting linkage disequilibrium analyses of 7 informative single nucleotide polymorphisms (SNPs) within the tetratricopeptide repeat domain 12 (TTC12)/ankyrin repeat and kinase containing 1 (ANKK1)/dopamine (D2) receptor gene cluster, we identified haplotype block structures in 270 Black and 368 White (n = 638) participants, from the Baltimore Epidemiologic Catchment Area cohort study, spanning the TTC12 and ANKK1 genes consisting of three SNPs (rs2303380-rs4938015-rs11604671). Informative haplotypes were examined for sex-specific associations with daily tobacco smoking initiation and cessation using longitudinal data from 1993-1994 and 2004-2005 interviews. Results: There was a Haplotype × Sex interaction such that Black men possessing the GTG haplotype who were smokers in 1993-2004 were more likely to have stopped smoking by 2004-2005 (55.6% GTG vs. 22.0% other haplotypes), while Black women were less likely to have quit smoking if they possessed the GTG (20.8%) versus other haplotypes (24.0%; p = .028). In Whites, the GTG haplotype (vs. other haplotypes) was associated with lifetime history of daily smoking (smoking initiation; odds ratio = 1.6; 95% CI = 1.1-2.4; p = .013). Moreover, there was a Haplotype × Sex interaction such that there was higher prevalence of smoking initiation with GTG (77.6%) versus other haplotypes (57.0%; p = .043). Discussion: In 2 different ethnic American populations, we observed man-woman variation in the influence of the rs2303380-rs4938015-rs11604671 GTG haplotype on smoking initiation and cessation. These results should be replicated in larger cohorts to establish the relationship among the rs2303380-rs4938015-rs11604671 haplotype block, sex, and smoking behavior.A prospective examination of distress tolerance and early smoking lapse in adult self-quitters
AbstractBrown, R. A., Lejuez, C. W., Strong, D. R., Kahler, C. W., Zvolensky, M. J., Carpenter, L. L., Niaura, R., & Price, L. H. (n.d.).Publication year
2009Journal title
Nicotine and Tobacco ResearchVolume
11Issue
5Page(s)
493-502AbstractIntroduction: A significant percentage of smokers attempting cessation lapse to smoking within a matter of days, and current models of relapse devote insufficient attention to such early smoking lapse. Studies attempting to relate severity of nicotine withdrawal symptoms to short-term smoking cessation outcomes have yielded equivocal results. How one reacts to the discomfort of nicotine withdrawal and quitting smoking (i.e., distress tolerance) may be a more promising avenue of investigation with important treatment implications. Methods: The present investigation examined distress tolerance and early smoking lapse using a prospective design. Participants were 81 adult daily smokers recruited through newspaper advertisements targeted at smokers planning to quit smoking without assistance (i.e., no pharmacotherapy or psychosocial treatment; 42 males and 39 females; mean age = 42.6 years, SD = 12.20). Results: As hypothesized, both greater breath-holding duration and carbon dioxide-enriched air persistence were associated with a significantly lower risk of smoking lapse following an unaided quit attempt. These effects were above and beyond the risk associated with levels of nicotine dependence, education, and history of major depressive disorder, suggesting that distress tolerance and task persistence may operate independently of risk factors such as nicotine dependence and depressive history. In contrast to expectation, persistence on the Paced Auditory Serial Addition Test (a psychological challenge task) was not a significant predictor of earlier smoking lapse. Discussion: These results are discussed in relation to refining theoretical models of the role of distress tolerance in early smoking lapse and the utility of such models in the development of specialized treatment approaches for smoking cessation.Adolescent tobacco use and substance abuse treatment outcomes
AbstractDe Dios, M. A., Vaughan, E. L., Stanton, C. A., & Niaura, R. (n.d.).Publication year
2009Journal title
Journal of Substance Abuse TreatmentVolume
37Issue
1Page(s)
17-24AbstractThis study investigated the relationship between cigarette-smoking status and 12-month alcohol and marijuana treatment outcomes in a sample of 1,779 adolescents from the Drug Abuse Treatment Outcomes Study for Adolescents. Participants were classified into four groups based on change in cigarette-smoking status from intake to the 12-month follow-up: persistent smokers, nonsmokers, quitters, and smoking initiators. Logistic regression was used to predict likelihood of relapse to alcohol, marijuana, and other drugs after controlling for intake levels and demographic/treatment characteristics. Results found persistent smokers and smoking initiators to have significantly greater odds of alcohol and marijuana relapse compared with quitters. Furthermore, persistent smokers and smoking initiators were also found to have distinctively shorter periods to marijuana relapse at follow-up. Implications for the implementation of tobacco cessation treatment in the context of substance abuse treatment for adolescents are discussed.HIV & smoking in India
AbstractRamesh Kumar, S., Swaminathan, S., Flanigan, T., Mayer, K. H., & Niaura, R. (n.d.).Publication year
2009Journal title
Indian Journal of Medical ResearchVolume
130Issue
1Page(s)
15-22AbstractThere are approximately 2.5 million people living with HIV/AIDS (PLWHA) in India - the young being particularly vulnerable. The prevalence of smoking has increased in India especially among rural, lower socio-economic and illiterate men. Studies have shown that HIV-infected smokers may be at additional risk for several infectious and non-infectious complications, including malignancies and cardiovascular events. Smoking alters immunological mechanisms and suppresses host defenses in the alveolar environment. HIV-infected smokers have also been found to have a poorer response to antiretroviral therapy and a higher risk of death. HIV-infected individuals who smoke could be at a greater risk for developing TB and subsequently suffer higher morbidity and mortality than those who do not smoke. Currently available smoking cessation interventions like physician's advice, nicotine replacement therapy and pharmacological agents like bupropion and varenicline have had varying degrees of success. Smoking cessation intervention in the HIV-infected population might be more complex because of associated psychosocial problems like drug addiction, alcoholism, depression, etc. More research including clinical trials testing the efficacy of smoking cessation interventions in HIV-infected persons is required in India. In addition to public health measures like banning smoking in public places and raising tobacco tax, comprehensive guidelines for health workers can help address this problem. Counselling on smoking cessation should be one of the main components of primary care, especially in the management of HIV-infected persons. This review highlights the importance of smoking cessation among HIV-infected persons in India.HIV, STD, and hepatitis risk behaviors of young men before and after incarceration
AbstractMorrow, K. M., Gaiter, J., MacGowan, R., Wolitski, R., Margolis, A., Belcher, L., Lifshay, J., McFarlane, M., O’Leary, A., Williamson, J. M., Eldridge, G., Askew, J., Fitterling, J., Fortenberry, M., Griebler, J., Kennedy, S., McGregor, S., Sturges, J., Vardaman, J., … Gregorich, S. (n.d.).Publication year
2009Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
21Issue
2Page(s)
235-243AbstractHigh rates of HIV, STD and hepatitis and associated risk behaviors have been documented among persons entering correctional facilities. However, there is a paucity of data on risk behaviors after release from custody. This study documents risk behaviors and informs intervention development targeting young men leaving incarcerated settings. We enrolled and interviewed 106 men from five prisons up to 60 days prior to their release from prison and interviewed them again four times after their release (at 1-week, 1-, 3- and 6-months). At enrollment, men were 18-29 years of age. Nearly 54% identified as African American, while 27% identified as White, 10% identified as Hispanic/Latino and 10% identified as "other". Approximately 83% had been incarcerated multiple times, 37% reported a prior STD diagnosis and their mean lifetime number of sex partners was 36 (median = 20). Many reported multiple sex partners and inconsistent condom use after release. A significant decrease in condom use during vaginal sex with primary committed female partners and in oral sex with both committed and casual female partners after release from prison were reported from 1-6 months. These young men are at sexual risk of HIV, STD and hepatitis infection after release from prison. Interventions are needed to prevent this population from acquiring and transmitting HIV, STD and hepatitis.Impact of bupropion and cognitive-behavioral treatment for depression on positive affect, negative affect, and urges to smoke during cessation treatment
AbstractStrong, D. R., Kahler, C. W., Leventhal, A. M., Abrantes, A. M., Lloyd-Richardson, E., Niaura, R., & Brown, R. A. (n.d.).Publication year
2009Journal title
Nicotine and Tobacco ResearchVolume
11Issue
10Page(s)
1142-1153AbstractIntroduction: Bupropion and cognitive-behavioral treatment (CBT) for depression have been used as components of treatments designed to alleviate affective disturbance during smoking cessation. Studies of treatment-related changes in precessation affect or urges to smoke are needed to evaluate the proposed mechanisms of these treatments. Methods: The present report examines affective trajectories and urges to smoke prior to, on quit day, and after quitting in a sample of 524 smokers randomized to receive bupropion versus placebo and CBT versus standard smoking cessation CBT. Results: Bupropion and/or CBT did not affect the observed decreases in positive affect and increases in negative affect prior to cessation. However, on quit day, observed levels of negative affect and urges to smoke were diminished significantly among individuals receiving bupropion. Decreases in positive affect prior to quitting, lower levels of positive affect, and increased levels of negative affect and urges to smoke on quit day were each related to higher risk of smoking lapse. Depression proneness was an independent predictor of lower positive affect and higher negative affect but did not moderate the effects of bupropion on outcomes. In mediational analyses, the effect of bupropion was accounted for in part by lower negative affect and urges to smoke on quit day. Discussion: Results support the efficacy of bupropion in reducing relapse risk associated with urges to smoke and negative affect and suggest the need to better understand the role of low positive affect as a risk factor for early lapse.Maternal smoking during pregnancy and neonatal behavior: A large-scale community study
AbstractStroud, L. R., Paster, R. L., Goodwin, M. S., Shenassa, E., Buka, S., Niaura, R., Rosenblith, J. F., & Lipsitt, L. P. (n.d.).Publication year
2009Journal title
PediatricsVolume
123Issue
5Page(s)
e842-e848AbstractOBJECTIVE. To investigate the influence of prospectively measured smoking during pregnancy on aspects of neonatal behavior in a large community sample. METHODS. Participants were mothers and infants from the Providence, Rhode Island, cohort of the National Collaborative Perinatal Project enrolled between 1960 and 1966. Mothers with pregnancy/medical complications and infants with medical complications and/or born premature or of low birth weight were excluded. The final sample included 962 mother-infant pairs, 23% of whom were black. Maternal smoking was measured prospectively at each prenatal visit. Neonatal behavior was assessed by using the Graham-Rosenblith Behavioral Examination of the Neonate. Items from the examination were reduced to 3 subscales: irritability, muscle tone, and response to respiratory challenge. RESULTS. Sixty-two percent of the sample reported smoking during pregnancy, with 24% of smokers reporting smoking 1 pack per day or more. We found a significant influence of maternal smoking exposure (none, moderate/less than 1 pack per day, heavy/1 pack per day or more) on irritability and muscle tone in the neonate, with exposed infants showing greater irritability and hypertonicity. Effects remained significant after controlling for significant covariates: maternal socioeconomic status, age, and race and infant birth weight and age. Posthoc tests suggested particular effects of heavy smoking on increased infant irritability and both moderate and heavy smoking exposure on increased muscle tone. CONCLUSIONS. In a large community sample, exposure to maternal smoking was associated with increased irritability and hypertonicity in neonates. Exposure to maternal smoking did not influence neonatal response to respiratory challenge. This study is the largest-scale investigation to date of the effects of maternal smoking (heavy and moderate) on examiner-assessed neonatal behavior. Given the associations between both maternal smoking and infant irritability and later behavioral dysregulation, results have important implications for early identification and intervention with at-risk offspring.Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days
AbstractStroud, L. R., Paster, R. L., Papandonatos, G. D., Niaura, R., Salisbury, A. L., Battle, C., Lagasse, L. L., & Lester, B. (n.d.).Publication year
2009Journal title
Journal of PediatricsVolume
154Issue
1Page(s)
10-16AbstractObjective: To examine effects of maternal smoking during pregnancy on newborn neurobehavior at 10 to 27 days. Study design: Participants were 56 healthy infants (28 smoking-exposed, 28 unexposed) matched on maternal social class, age, and alcohol use. Maternal smoking during pregnancy was determined by maternal interview and maternal saliva cotinine. Postnatal smoke exposure was quantified by infant saliva cotinine. Infant neurobehavior was assessed through the NICU Network Neurobehavioral Scale. Results: Smoking-exposed infants showed greater need for handling and worse self-regulation (P < .05) and trended toward greater excitability and arousal (P < .10) relative to matched, unexposed infants (all moderate effect sizes). In contrast to prior studies of days 0 to 5, no effects of smoking-exposure on signs of stress/abstinence or muscle tone emerged. In stratified, adjusted analyses, only effects on need for handling remained significant (P < .05, large effect size). Conclusions: Effects of maternal smoking during pregnancy at 10 to 27 days are subtle and consistent with increased need for external intervention and poorer self-regulation. Along with parenting deficits, these effects may represent early precursors for long-term adverse outcomes from maternal smoking during pregnancy. That signs of abstinence shown in prior studies of 0- to 5-day-old newborns did not emerge in older newborns provides further evidence for the possibility of a withdrawal process in exposed infants.Mediators of the relationship between nicotine replacement therapy and smoking abstinence among people living with HIV/AIDS
AbstractStanton, C. A., Lloyd-Richardson, E. E., Papandonatos, G. D., De Dios, M. A., & Niaura, R. (n.d.).Publication year
2009Journal title
AIDS Education and PreventionVolume
21Page(s)
65-80AbstractCigarette smoking is highly prevalent among people living with HIV/AIDS and poses unique health risks. Smoking cessation programs tailored to this population have documented improved smoking outcomes with nicotine replacement therapy (NRT). The current study examined 6-month abstinence rates from a randomized clinical trial targeting 412 HIV-positive adult current smokers (51% European American, 19% African American, and 17% Hispanic American) and tested whether psychosocial variables, such as self-efficacy and decisional balance, mediated the relationship between NRT and long-term abstinence. Meeting criteria for complete mediation, 6-month smoking abstinence rates improved significantly with increases in these mediators, and the association of NRT and smoking abstinence was no longer significant once changes in self-efficacy and decisional balance were taken into account. Failure to translate gains in self-efficacy among African Americans into improved abstinence rates accounted for racial/ ethnic differences among participants. Specific psychosocial factors, such as self-efficacy, may be particularly amenable to change in cessation interventions and should be addressed with greater awareness of how cultural and social contextual factors impact treatment response among people living with HIV/AIDS.Motivation and patch treatment for HIV+ smokers: A randomized controlled trial
AbstractLloyd-Richardson, E. E., Stanton, C. A., Papandonatos, G. D., Shadel, W. G., Stein, M., Tashima, K., Flanigan, T., Morrow, K., Neighbors, C., & Niaura, R. (n.d.).Publication year
2009Journal title
AddictionVolume
104Issue
11Page(s)
1891-1900AbstractAims To test the efficacy of two smoking cessation interventions in a HIV positive (HIV+) sample: standard care (SC) treatment plus nicotine replacement therapy (NRT) versus more intensive motivationally enhanced (ME) treatment plus NRT. Design Randomized controlled trial. Setting HIV+ smoker referrals from eight immunology clinics in the northeastern United States. Participants A total of 444 participants enrolled in the study (mean age = 42.07 years; 63.28% male; 51.80% European American; mean cigarettes/day = 18.27). Interventions SC participants received two brief sessions with a health educator. Those setting a quit date received self-help quitting materials and NRT. ME participants received four sessions of motivational counseling and a quit-day counseling call. All ME intervention materials were tailored to the needs of HIV+ individuals. Measurements Biochemically verified 7-day abstinence rates at 2-month, 4-month and 6-month follow-ups. Findings Intent-to-treat (ITT) abstinence rates at 2-month, 4-month and 6-month follow-ups were 12%, 9% and 9%, respectively, in the ME condition, and 13%, 10% and 10%, respectively, in the SC condition, indicating no between-group differences. Among 412 participants with treatment utilization data, 6-month ITT abstinence rates were associated positively with low nicotine dependence (P = 0.02), high motivation to quit (P = 0.04) and Hispanic American race/ethnicity (P = 0.02). Adjusting for these variables, each additional NRT contact improved the odds of smoking abstinence by a third (odds ratio = 1.32, 95% confidence interval = 0.99-1.75). Conclusions Motivationally enhanced treatment plus NRT did not improve cessation rates over and above standard care treatment plus NRT in this HIV+ sample of smokers. Providers offering brief support and encouraging use of nicotine replacement may be able to help HIV+ patients to quit smoking.Parental smoking and adolescent smoking initiation: An intergenerational perspective on tobacco control
AbstractGilman, S. E., Rende, R., Boergers, J., Abrams, D. B., Buka, S. L., Clark, M. A., Colby, S. M., Hitsman, B., Kazura, A. N., Lipsitt, L. P., Lloyd-Richardson, E. E., Rogers, M. L., Stanton, C. A., Stroud, L. R., & Niaura, R. S. (n.d.).Publication year
2009Journal title
PediatricsVolume
123Issue
2Page(s)
e274-281AbstractOBJECTIVE. Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relationship between parental smoking and the risk of smoking initiation during adolescence. This study investigates unresolved issues concerning the strength and nature of the association between parent smoking and offspring smoking initiation. METHODS. We enrolled 564 adolescents aged 12 to 17, along with 1 of their parents, into the New England Family Study between 2001 and 2004. Lifetime smoking histories were obtained from parents and their adolescent offspring. Discrete-time survival analysis was used to investigate the influence of parental smoking histories on the risk of adolescent smoking initiation. RESULTS. Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring. In addition, the likelihood of offspring smoking initiation increased with the number of smoking parents and the duration of exposure to parental smoking, suggesting a dose-response relationship between parental smoking and offspring smoking. Offspring of parents who had quit smoking were no more likely to smoke than offspring of parents who had never smoked. The effects of parental smoking on offspring initiation differed by sex (with a stronger effect of fathers' smoking on boys than girls), developmental period (with a stronger effect of parental smoking before the adolescent was age 13 than afterward), and residence of parents (with effects of fathers' smoking being dependent on living in the same household as the adolescent). Parental smoking was also associated with stronger negative reactions to adolescents' first cigarette, a potential marker of the risk of progression to higher levels of use. CONCLUSIONS. Parental smoking is an important source of vulnerability to smoking initiation among adolescents, and parental smoking cessation might attenuate this vulnerability.Parenting practices, parent smoking, and friend smoking influences on stages of adolescent smoking
Stanton, C., Papandonatos, G., Lloyd-Richardson, E., Su, S., Kazura, A., & Niaura, R. (n.d.).Publication year
2009Journal title
Adolescent & Family HealthVolume
4Issue
2Page(s)
71-85Personality, psychiatric disorders, and smoking in middle-aged adults
Prevalence and characteristics of multiple psychiatric disorders in cardiac rehabilitation patients
AbstractSerber, E. R., Todaro, J. F., Tilkemeier, P. L., & Niaura, R. (n.d.).Publication year
2009Journal title
Journal of Cardiopulmonary Rehabilitation and PreventionVolume
29Issue
3Page(s)
161-168AbstractPURPOSE: Anxiety and depressive disorders have been established as independent risk factors for the development of and recovery from coronary heart disease (CHD). However, few studies have reported on the prevalence and personal characteristics of comorbid psychiatric disorders (PD) among cardiac populations. This project examined the prevalence of comorbid depressive and anxiety disorders among men and women with CHD commencing cardiac rehabilitation (CR) and the demographic, medical, and psychosocial characteristics among those meeting multiple PD criteria. METHODS: Participants were 143 CHD patients (M age, 61 years; SD, 11.2; 70% men, 91% Caucasian, 64% married) entering CR who were evaluated via a semistructured, psychiatric interview to assess both current and lifetime prevalence rates of PD. Demographic, medical, and psychosocial variables were also assessed. RESULTS: Approximately 45% met criteria for at least 1 anxiety disorder, and 20% met criteria for either major depressive disorder or dysthymic disorder either at the time of evaluation or in their lifetime. Across all participants, 26% met criteria for ≥2 PD. Of those with a depressive disorder, 76% also met criteria for at least 1 anxiety disorder. Participants with comorbid PD were of younger age and female and reported less education (P < .01). Comorbidity was also associated with self-reported overall diminished physical, emotional, and social quality of life, depression, and anxiety. CONCLUSION: Comorbid PD are highly prevalent in the CR setting and are associated with specific demographic characteristics and reduced quality of life. These data offer additional support that routine screening for PD is warranted in outpatient cardiac settings.Regular exercise as a protective factor in relapse following smoking cessation treatment
Abrantes, A. M., Strong, D. R., Lloyd-Richardson, E. E., Niaura, R., Kahler, C. W., & Brown, R. A. (n.d.). In American Journal on Addictions (1–).Publication year
2009Volume
18Issue
1Page(s)
100-101Smoking abstinence and reinstatement effects in adolescent cigarette smokers
AbstractColby, S. M., Leventhal, A. M., Brazil, L., Lewis-Esquerre, J., Stein, L. A., Rohsenow, D. J., Monti, P. M., & Niaura, R. S. (n.d.).Publication year
2009Journal title
Nicotine and Tobacco ResearchVolume
12Issue
1Page(s)
19-28AbstractIntroduction: The study objectives were to examine smoking abstinence and reinstatement effects on subjective experience and cognitive performance among adolescent smokers. Methods: Adolescents (aged 14-17 years, 60 daily smokers and 32 nonsmokers) participated. Participants completed baseline assessments (Session 1) and returned to the laboratory 1-3 days later to repeat assessments (Session 2); half of the smokers were randomly assigned to 15-17 hr tobacco abstinence preceding Session 2. Results: During Session 2, abstaining smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Smoking reinstatement reversed abstinence effects, returning to baseline levels for smoking urges and negative affect. Abstaining smokers showed significantly enhanced cognitive performance on two of six tasks (two-letter search compared with nonabstaining smokers; serial reaction time compared with nonsmokers); smoking reinstatement resulted in significant decrements on these two tasks relative to nonabstaining smokers. Discussion: Effects of smoking abstinence and reinstatement on self-report measures are consistent with earlier research with adolescent as well as adult smokers and may help to elucidate the motivational underpinnings of smoking maintenance among adolescent smokers. Effects found on cognitive performance were contrary to hypotheses; further research is needed to understand better the role of cognitive performance effects in smoking maintenance among adolescents.Stress response and the adolescent transition: Performance versus peer rejection stressors
AbstractStroud, L. R., Foster, E., Papandonatos, G. D., Handwerger, K., Granger, D. A., Kivlighan, K. T., & Niaura, R. (n.d.).Publication year
2009Journal title
Development and PsychopathologyVolume
21Issue
1Page(s)
47-68AbstractLittle is known about normative variation in stress response over the adolescent transition. This study examined neuroendocrine and cardiovascular responses to performance and peer rejection stressors over the adolescent transition in a normative sample. Participants were 82 healthy children (ages 7-12 years, n = 39, 22 females) and adolescents (ages 13-17, n = 43, 20 females) recruited through community postings. Following a habituation session, participants completed a performance (public speaking, mental arithmetic, mirror tracing) or peer rejection (exclusion challenges) stress session. Salivary cortisol, salivary alpha amylase (sAA), systolic and diastolic blood pressure (SBP, DBP), and heart rate were measured throughout. Adolescents showed significantly greater cortisol, sAA, SBP, and DBP stress response relative to children. Developmental differences were most pronounced in the performance stress session for cortisol and DBP and in the peer rejection session for sAA and SBP. Heightened physiological stress responses in typical adolescents may facilitate adaptation to new challenges of adolescence and adulthood. In high-risk adolescents, this normative shift may tip the balance toward stress response dysregulation associated with depression and other psychopathology. Specificity of physiological response by stressor type highlights the importance of a multisystem approach to the psychobiology of stress and may also have implications for understanding trajectories to psychopathology.Transdisciplinary Tobacco Use Research Centers: research achievements and future implications.
Baker, T. B., Cummings, K. M., Hatsukami, D. K., Johnson, C. A., Lerman, C., Niaura, R., & O’Malley, S. S. (n.d.).Publication year
2009Journal title
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and TobaccoVolume
11Issue
10Page(s)
1231-1244Anxiety Characteristics Independently and Prospectively Predict Myocardial Infarction in Men. The Unique Contribution of Anxiety Among Psychologic Factors
AbstractShen, B. J., Avivi, Y. E., Todaro, J. F., Spiro, A., Laurenceau, J. P., Ward, K. D., & Niaura, R. (n.d.).Publication year
2008Journal title
Journal of the American College of CardiologyVolume
51Issue
2Page(s)
113-119AbstractObjectives: This study investigated whether anxiety characteristics independently predicted the onset of myocardial infarction (MI) over an average of 12.4 years and whether this relationship was independent of other psychologic variables and risk factors. Background: Although several psychosocial factors have been associated with risk for MI, anxiety has not been examined extensively. Earlier studies also rarely addressed whether the association between a psychologic variable and MI was specific and independent of other psychosocial correlates. Methods: Participants were 735 older men (mean age 60 years) without a history of coronary disease or diabetes at baseline from the Normative Aging Study. Anxiety characteristics were assessed with 4 scales (psychasthenia, social introversion, phobia, and manifest anxiety) and an overall anxiety factor derived from these scales. Results: Anxiety characteristics independently and prospectively predicted MI incidence after controlling for age, education, marital status, fasting glucose, body mass index, high-density lipoprotein cholesterol, and systolic blood pressure in proportional hazards models. The adjusted relative risk (95% confidence interval [CI]) of MI associated with each standard deviation increase in anxiety variable was 1.37 (95% CI 1.12 to 1.68) for psychasthenia, 1.31 (95% CI 1.05 to 1.63) for social introversion, 1.36 (95% CI 1.10 to 1.68) for phobia, 1.42 (95% CI 1.14 to 1.76) for manifest anxiety, and 1.43 (95% CI 1.17 to 1.75) for overall anxiety. These relationships remained significant after further adjusting for health behaviors (drinking, smoking, and caloric intake), medications for hypertension, high cholesterol, and diabetes during follow-up and additional psychologic variables (depression, type A behavior, hostility, anger, and negative emotion). Conclusions: Anxiety-prone dispositions appear to be a robust and independent risk factor of MI among older men.Can the blind see? Participant guess about treatment arm assignment may influence outcome in a clinical trial of bupropion for smoking cessation
AbstractSchnoll, R. A., Epstein, L., Audrain, J., Niaura, R., Hawk, L., Shields, P. G., Lerman, C., & Wileyto, E. P. (n.d.).Publication year
2008Journal title
Journal of Substance Abuse TreatmentVolume
34Issue
2Page(s)
234-241AbstractIn a placebo-controlled bupropion smoking cessation trial, we examined blind integrity, the link between blind integrity and quit rates, and whether side effects and changes in nicotine withdrawal symptoms or mood were mechanisms through which blind integrity is threatened. At a 12-month follow-up, 498 participants indicated whether they thought they received bupropion, placebo, or were not sure. Potential mediators of treatment effects on treatment arm guess (i.e., side effects, withdrawal, and mood) were measured during treatment, and 7-day point prevalence cessation was assessed at the end of treatment (EOT) and at 6 and 12 months after quit date. Overall, 55% of participants guessed their randomization correctly. Compared to guessing not sure, participants who guessed they were taking bupropion were more than twice as likely to have been randomized to bupropion. Similarly, participants who guessed placebo were twice as likely to have been randomized to placebo. Treatment arm guess was associated with quit rates. Including treatment arm guess with actual treatment arm in models of quit rates significantly reduced the odds ratio for bupropion efficacy at the EOT and at 6 and 12 months after quit date. There was no evidence for mediation. In bupropion smoking cessation trials, blind failure may occur and participant guess about treatment arm assignment is associated with quit rates.